¹Hepatology, The Johns Hopkins University School of Medicine, Baltimore, Maryland

Correspondence: Paul J. Thuluvath, MD, FRCP, Director of Hepatology, The Johns Hopkins Hospital, 1830 E. Monument Street, Baltimore, MD 21205

Received 3 September 2005; Revised  0000; Accepted 26 October 2005.

Abstract

Cryptogenic cirrhosis (CC), literally meaning cirrhosis of obscure or unknown origin, is a diagnosis of exclusion. The circumstantial evidence indicates that nonalcoholic fatty liver disease (NAFLD) is perhaps one of the important causes of CC. There is also evidence, especially from the European literature, that some patients with CC may have undiagnosed or burnt-out autoimmune hepatitis (AIH). Other rare causes may include "unknown" viral (non-A, non-B, non-C) hepatitis, and occult alcoholism. In this review, we examine the role of NAFLD and other causes in the pathogenesis of CC, and the impact of obesity on patients with chronic liver disease.